Conundrums and Controversies

Monthly Archives: May 2013

On being ‘pro-choice’: abortion, voluntary euthanasia and assisted suicide

Sometimes it is possible to predict, with a reasonable chance of being right, what a person’s views are on one matter, simply by knowing what their views are on another. This may not be because there is any logical connection between holding the one view and holding the other as well. Indeed, because few or none of us are consistent all the time, we may falsely predict a person’s opinion on an issue simply because we wrongly assume they have logical minds. Often, the reason why we are accurate is that we have noticed similarities between those who hold a particular view on one matter, and those who hold a particular view on another. Hence, if we know that someone is a feminist, we may think it more likely than not that they have a tolerant view of mass immigration. If we know that someone supports the death penalty, we may think it more likely than not that they support enhanced stop and search powers for the police.

Sometimes, however, we find unexpected combinations of opinions in people. Such people are difficult to ‘pigeon-hole’. We might be surprised to find a feminist who supports stronger immigration controls, or a death penalty advocate who wants to curb the powers of the police. The surprise arises, not because there is any logical connection between (say) opinions about feminism and opinions about immigration, but because both views tend to be informed by more general principles – about the value of individual freedom, say. So when we find someone with an initially surprising mixture of views, we wonder whether they are simply confused, or whether – on the contrary – they have an above-average logical acumen, that enables them to see that that there are, in fact, no logical connections between two views, even though it is generally thought that there are.

There are two ‘bread and butter’ controversies in medical ethics – abortion and voluntary euthanasia – that often bring this issue to my mind. Quite often, one can predict what a person’s views are about the one issue, from knowing their views on the other. Thus ‘pro-life’ advocates concerning abortion also tend to be anti-euthanasia, and ‘pro-choice’ advocates of abortion rights also tend to support the legalization of voluntary euthanasia. It is clear what the underlying thinking usually is, for both cases. If the sanctity – or at least, the supreme value – of human life is seen as fundamental to a decent system of values, then assuming that both abortion and euthanasia are the deliberate taking of human life, both are thought, by some people, to be wrong. On the other hand, if respecting individual choice about whether to be a mother, or whether to go on living is seen as fundamentally important, then we can expect those who hold this view to say that the law should allow both, subject (no doubt) to appropriate regulation.

What particularly interests me, however, is that there are some thinkers who take an unyielding line against voluntary euthanasia, even though they are staunch supporters of a ‘woman’s right to choose’ abortion. Many of them describe themselves as libertarian, and some have written on either or both subjects for the online magazine spiked (www.spiked-online.com). I recommend readers to have a look at some of the pieces. Indeed, they are pretty absolutist when it comes to abortion: in their view, neither consequences nor circumstances should count against a woman’s right to have an abortion, at any stage of pregnancy, if she so chooses. Her reasons do not have to be ‘good’ ones – such as gross fetal abnormality or any threat the continuation of pregnancy might pose to the woman. It is sufficient simply that she makes this choice. In other words, on this view abortion should be available on demand.

Why then, I often ask myself, do some such people oppose voluntary euthanasia? It is, on the face of it, remarkable that they do. Are there deep inconsistencies in their thinking, or are there subtle ways in which these two opinions may be reconciled?

In general, if two views seem to be inconsistent with each other, we cannot decide whether or not they really are unless we know what general principle(s) each is derived from. For example, people often say it is inconsistent to oppose abortion but favour the death penalty: if you are against abortion because it is killing, then you should be against the death penalty because it, too, is killing. This observation is commonly used to show how stupid ‘pro-life’ supporters of capital punishment are. But it is pertinent only if the major premise is that all taking of human life is wrong. Reasonably intelligent death penalty advocates do not actually say this; what they usually say is that it is always wrong to take innocent human life deliberately. Human fetuses are innocent; murderers are not. So although some people might find this combined stance repellent, those holding to it may not be guilty of any inconsistency.

Correspondingly, there may be no inconsistency between supporting abortion rights, but opposing the ‘right to die’. What is crucial is the grounds offered for each judgement. If you support abortion rights but not the ‘right to die’, on the ground that overall human welfare is likely to be advanced by the first, but not by the second, you are not guilty of any inconsistency: the principle you start from is, roughly, that laws should be passed if they promote net human welfare, but not otherwise. Hence, the dispute then concerns whether or not liberal laws on abortion or euthanasia really do this. However, many of those who support a ‘woman’s right’ to abortion do not base their view on this alone. They say there should be a right to abortion. And rights operate as a protective fence against other considerations, such as those of consequences or circumstances. Hence, even if the fetus/baby/unborn child (or whatever it should be called) has good prospects of a satisfying life, and even if the pregnant woman is unlikely to suffer any serious harm from giving birth or rearing the child, she should still be granted the right to abortion. For such a right reflects the paramount importance of allowing women to decide what happens in and to their own bodies. For many people, this is just fundamental and self-evident.

Of course, this is a relatively strong formulation of the ‘pro-choice’ position. Other more moderate views are possible, as well as different arguments in its support. But I shall concentrate on this simple version, because it points to an interesting parallel with the case for the ‘right to die’ – i.e. to voluntary euthanasia, or to assisted suicide. If there is at least one sound argument for an absolute (or at least, nearly absolute) right to abortion, does such an argument also support the ‘right to die’?

Those who combine a pro-choice view about abortion with opposition to voluntary euthanasia often defend their views on euthanasia with some fairly well-known objections to it. For example, we are familiar with the worry that legalizing voluntary euthanasia or assisted suicide could lead us down a slippery slope, with non-voluntary euthanasia and ‘encouraged’ suicide lying at the bottom. We are also told that such changes in the law would be harmful to palliative care provision. These considerations do have weight, although the empirical predictions are hard to assess from the armchair. But for those who argue for the ‘right to die’ – which should really be re-phrased as the view that there should be no law against euthanasia or assisted suicide if a patient genuinely and competently desires it – the important consideration is that this ‘right’ should be granted, even if bad consequences follow. That is the point of having a right – it is a claim that has free-standing moral force. Exercising one’s rights may, of course, be imprudent or have undesirable consequences for others. Sometimes it can even be morally wrong to exercise one’s rights – as when I mean-spiritedly refuse to lend someone a book that they need for urgent exam revision. But the right, if it is accepted as such, retains its moral force. It cannot simply be weighed up against the bad consequences of exercising it.

I am not saying here that there is, or should be, such a right. I am trying to ask whether, if we grant women a right to abortion, and regard this right as trumping all or almost all other considerations that may be brought against abortion, we should also grant those desiring euthanasia or assisted suicide a right to those things. Why might we believe in the right to abortion? A powerful and frequently used argument is that a woman’s body is her own, and she should not be forced to allow a fetus to live off her body, if she does not want to. (I do not say this is a decisive argument – that is another question). But if we accept this view, then we face a challenge: why not use a parallel argument to support the ‘right to die’? If it is wrong legally to deny a woman an abortion if she is unwillingly pregnant, why is it not also wrong legally to deny someone euthanasia or assistance in committing suicide, if that is what they have competently chosen?

Thus my point should be seen as a question rather than a conclusion. As it happens, I think the arguments around both abortion and assisted dying are highly complex. I often wonder whether both disputes are intractable. But the question, for the moment, is simple: if we should grant women an absolute (or perhaps nearly absolute) right to abortion, on grounds of a right to bodily self-determination, why should the same consideration – that my living body is my own, and not for others to determine its fate – not ground a ‘right to die’?